Cost pressures and cost control have been the main forces driving the rapid changes taking place in the U.S. health care system and the rapidly growing managed care industry. However, there is another trend emerging from the employer/purchaser side of the marketplace - value based health care purchasing. This trend makes the quality Of Care and health plan administration the main goal for improving the system while reduCing costs thrOugh the elimination of waste. This AHCPR small conference will explore the first independent evaluation of these new health care purchasing initiatives which may have a profound effect on public and private health Care services and plans. For the past eighteen months, the Midwest Business Group on Health (MBGH) and the Economic and Social Research Institute (ESRI) have been working together to evaluate health care purchasing initiatives of a selected group of communities across the country. Supported by the Robert Wood Johnson Foundation; and guided by an advisory board of business leaders, health policy experts, legislators, and health coalition executives; this study is now ready to be communicated to a national audience: health policy leaders and employer leaders who purchase health care across the nation. Articles will be submitted for publication based on the findings of the study and the discussion of their implications for the two target audiences attending this conference. Help employers who are evaluating their purchasing initiatives to use the criteria and standards developed for this study, and to compare their findings with the study results. Stimulate employers not formally engaged with their health care providers and health plans to initiate value-based purchasing arrangements for the future.